by Jackie Kucinich, USA TODAY

by Jackie Kucinich, USA TODAY

Mental health advocates, heartened when their cause took center stage in the wake of the mass shooting in Newtown, Conn., are now looking past the gun debate with the hope of having a more positive discussion about the issue.

Days after the shooting in Newtown that left 20 school children and six educators dead inside Sandy Hook Elementary school by a man with a history of mental illness, even the most skittish lawmakers on gun control pointed to mental health care as an area they were open to exploring.

But with the focus primarily on how to prevent mentally ill people from obtaining weapons rather than improving care, mental health advocates now worry the connection has increased the stigma around the mentally ill that they have worked for decades to break down.

Carolyn Reinach Wolf, director of the mental health practice at Abrams and Fensterman, a New York-based law firm, said while the issues of gun violence and mental health are clearly linked in the recent mass shootings, the issue of mental health is so large that it should be dealt with separately from the gun discussion. But Wolf said she worried that without the urgency surrounding the debate over gun violence the issue would fall away, as it had after previous mass shootings.

"I just don't want it to be a forgotten issue, the more you read and hear, the more it has become the forgotten issue yet again," she said.

The VERA Institute of Justice issued a policy paper warning that mental health should be dealt with as a public health issue, rather than a criminal justice issue. And, predicting violent behavior is difficult even for professionals.

"There's not a one-to-one link between risk of mental health and risk of violence," said Evan Elkin, planning director of government innovation for VERA.

Congressional advocates of expanding mental health said Tuesday that while the gun debate had brought the issue to the forefront, the conversation and the push to make changes to the mental health issue would continue. The White House budget in part ensures the debate will continue due to $235 million for new mental health programs, according to The Washington Post.

Sen. Debbie Stabenow, D-Mich., said Tuesday she plans to offer her bill to help expand and improve the availability of mental health services for people with mental illnesses, as an amendment to the larger gun bill but would offer it as a stand-alone measure if it fails to pass. "It's really a moment for us to step up and present a positive solution on this," she said.

Sen. Jon Tester, D-Mont., who has co-sponsored legislation with Stabenow, said Congress must be extremely careful how they deal with the mental health issue in connection with the gun bill in order to avoid further stigmatizing mental illness.

Tester said during his recent trip home to Montana, he spoke to several veterans who told him about people they knew who refused to seek treatment for their mental illnesses. The threat of being added to the list of individuals who are ineligible to purchase a firearm worried them, he said. "We've got to be very careful how we do this, we've got to make sure we do not discourage people from getting the health care they need, we've got to make sure our definitions are airtight," Tester said. "I think it can be done and I think it will be done."

Mental health advocates say that while the issues of gun violence and mental health may be linked, the legislative approach should focus more on bills such as Stabenow's, that make access to care easier for those who need it.

"We need to appreciate that people with mental illness are no more likely to commit violence than people who do not have a mental health condition," said Julio Abreu, senior director of government affairs at Mental Health America. "People with mental health conditions are more likely to be victims of violent acts than perpetrators of violent acts."

But he said, for the time being - like it or not - the two issues are linked "for better or worse."

Wayne Lindstrom, president and CEO of Mental Health America, said it is equally likely that the debate could help or hurt the mental health community in their mission to destigmatize mental illness.

"I think there's some real potential here with elevating the conversation to leverage that into better social policy," he said, adding that President Obama's decision to launch a "national conversation" on mental health in the coming months could be particularly helpful.

The mental health provisions that are expected to be included in the gun bills have mostly to do with strengthening penalties on states who fail to update data in the National Instant Criminal Background Check System to include those who are prohibited from owning a gun, including those barred due because they were "adjudicated as a mental defective or has been committed to any mental institution."